HIGH FIVES AND A TOWEL TO WIPE UP YOUR PEE :NOT MY IDEA OF A GOOD EXERCISE CHOICEBy Kim Vopni

I first heard about CrossFit 6 years ago when a previous co-worker started posting the workouts on his Facebook page. CrossFit involves high intensity strength and conditioning workouts called WOD’s – workout of the day – which could include anything from burpees to clean and jerks to pull ups to double unders. Back then, CrossFit was gaining quite a following, mainly amongst men but in the last 2-3 years it has become increasingly popular amongst women. About 50% of the people who come to see me for help with their mummy tummy and/or their leaking, have either been doing CrossFit for awhile or have just started it. Simply said, I just don’t get it. This post aims to offer a bit of insight into why I feel there are better choices than CrossFit, and other extreme bootcamp style workouts for women, in particular women who have had children. Sure, it can help you build bulging biceps and stronger quads, but it is at the expense of your inner core, namely your pelvic floor - your foundation. If your foundation is weak (which it is if you are leaking or have mummy tummy), all the double unders in the world will never make it strong again and it puts you at an even greater risk of injury in your workouts as well.

The pelvic floor (I am focusing on the female pelvic floor in this post) is a group of muscles, connective tissue and ligaments that support the spine and pelvis; this group helps control your continence (when you pee, poo or fart); it plays a key role in your sexual health (it is integral in the enjoyment factor and it also makes sure you don’t pee poo or fart during it), and helps keep your internal organs in place (the bladder, the uterus and the rectum). This is all very important stuff don’t you think? The pelvic floor is your foundation and when it is performing optimally the spine and pelvis are supported, movement is anticipated, breathing is optimized, organs are in place and there is no leaking of urine. Many CrossFit exercises unfortunately do not support the female pelvic floor, but rather challenge it to such a degree that it loses its ability to do its job and when you start doing high intensity exercise like CrossFit with an already compromised core (which most people have these days because of the lack of natural movement we do in a day) it loses its ability to do its job even quicker. A viral video several months ago demonstrated this very clearly and unfortunately sent the message that leaking urine during a WOD is not only “normal” but almost a badge of honour. It’s not. Leaking urine is NOT normal. It is a very clear indication that something is not working as it should and the signals will only get louder until you stop and listen to your body and do something about it. High fives and a towel to wipe up your pee is to me, just not acceptable.

Most women say they choose CrossFit to get stronger. Let me ask you this - is pushing yourself so hard that you lose control of your bladder your idea of building a stronger body? If you leak, your pelvic floor has lost its ability to control the function of elimination properly. Keep it up and your floor will eventually lose its ability to support the bladder all together and it (yes, the bladder) will start to protrude into and eventually out of the vagina (called pelvic organ prolapse). It may happen gradually over time, but it can also happen in an instant during a box jump, a clean and jerk, or a ball slam to name a few. And it isn’t just CrossFit – any activity or movement or exercise that increases intra-abdominal pressure so much, so often, should be avoided. We all need some intra-abdominal pressure for spinal stability but in a compromised core we lose the ability to manage the pressure and then well-intentioned exercise becomes a recipe for pelvic floor disaster.

Most women who have had babies have compromised cores. During pregnancy the posture changes with the weight of the growing uterus which affects the position of the pelvic floor, hormones influence the ligaments and connective tissue that support the pelvic floor and internal organs, the abdomen becomes stretched and weak, and the pelvic floor carries an ever- increasing load - and that is all before the actual birth! Women give birth vaginally or through a caesarean both of which can greatly impact the inner core. Many new moms are left with an unstable pelvis, diastasis recti (abdominal muscle separation) and some degree of nerve damage. At 6-weeks, a new mom is given a ‘green light’ to go back to exercise which quite frankly I find irresponsible. Not all exercise is created equal and most moms who want to lose the baby weight and get rid of their mummy tummy will often choose bootcamp style workouts and CrossFit is like bootcamp on steorids. I have said it before and I will say it again “mommy” and “bootcamp” do not belong in the same sentence.

The first paragraph on the CrossFit website states that CrossFit is “the principal strength and conditioning program for many police academies and tactical operations teams, military special operations units, champion martial artists, and hundreds of other elite and professional athletes worldwide” It then goes on to say that “Our program delivers a fitness that is, by design, broad, general, and inclusive. Our specialty is not specializing. Combat, survival, many sports, and life reward this kind of fitness and, on average, punish the specialist.” New moms and even ‘seasoned’ moms are definitely a specialty group and if CrossFit does not specialize in ‘specializing’ then there really aren’t a lot of modifications to offer. I caution all pregnant women and new moms reading this choose other alternatives for getting your body back. Good choices are walking, swimming, spinning and ultimately, just sitting less and moving more throughout your day. Take the stairs not the elevator, walk to the store instead of driving, sit in a wide leg forward bend (yoga pose) position when you play with your kids on the floor, use a squatty potty for elimination, put your laptop on the counter instead of on your lap all day – just move and change it up and do different things instead of driving to work, sitting at your desk all day and then going to bootcamp for an hour to try and get fit. It is not how we were designed to live or to move and if CrossFit or Insanity or P90X are your thing and you just can’t give them up then I strongly urge you to see a pelvic floor physiotherapist and a post-natal fitness specialist to determine if your core is automated and able to withstand the forces of this style of exercise.

For women who have never had children, you may not have the above mentioned challenges (yet) that women who have had children face but keep in mind the female pelvis is different than the male pelvis and you are still at a greater risk of developing pelvic floor challenges. The female pelvis is wider and more circular then the narrower, heart shaped male pelvis. Men also do not have a vagina where organs can descend into or a uterus or the fluctuating hormones that women have. Women should respect these differences and choose exercise that supports their pelvic floor and core rather than exercise that puts it at risk.

For all of you reading this who are leaking when you exercise, CrossFit or not, I urge you to stop and see a pelvic floor physiotherapist. It is not normal to leak and there is help.

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The contents of pelvicorganprolapsesupport.org is intended to provide beneficial health and support information for women who suspect they are experiencing or have been diagnosed with pelvic organ prolapse. All materials including text, graphics, images, and audio provided in this site are for informational purposes only and are not a substitute for guidance by a healthcare practitioner. Neither pelvicorganprolapsesupport.org nor APOPS recommends any particular medical procedure. APOPS encourages women to take all POP educational information to your personal clinician for further evaluation.